Hhqm15 Hhqm-pcr

Centers for Medicare & Medicaid Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
HHQM-PCR PRA document
Version 1.0
08/22/2017

Document Number: 173-QSSI-MACPro-PRA-HHQM-PCR-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

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Table of Contents

Table of Contents
1. Health Homes Quality Measure .............................................................................. 1
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
1.15
1.16

Plan All-Cause Readmission Rate (PCR) - Path 1 .......................................... 1
Measure Specification - Path 1 ....................................................................... 2
Measurement Specification - Path 2 ............................................................... 2
Date Range ..................................................................................................... 3
Definition of Population Included in the Measure ............................................ 3
Delivery Systems ............................................................................................ 4
Health Home Providers Representation .......................................................... 4
Performance Measure (Checked all age range) Path - 1 ................................ 5
Performance Measure (Checked one age range) Path – 2 ............................. 5
Age Range 65 and older, Path 1 ..................................................................... 6
Age Range 65 and older, Path 2 ..................................................................... 6
Other Performance Measure ........................................................................... 7
Deviations from Measure Specifications ......................................................... 7
Optional Measurement Stratification ............................................................... 8
Final Comments and Report Documents ...................................................... 12
Plan All-Cause Readmission Rate (PCR) – Path 2 ....................................... 12

Appendix A:

Acronyms ....................................................................................... 14

List of Figures
Figure 1: PCR Reporting – Yes ....................................................................................... 1
Figure 2: Measurement Specification 1 ........................................................................... 2
Figure 3: Measurement Specification 2 ........................................................................... 2
Figure 4: Date Range ...................................................................................................... 3
Figure 5: Definition of Population Included in this Measure 1 .......................................... 3
Figure 6: Definition of Population Included in the Measure 2 .......................................... 4
Figure 7: Definition of Population Included in the Measure 3 .......................................... 4
Figure 8: Performance Measure 1 ................................................................................... 5
Figure 9: Performance Measure 2 ................................................................................... 5
Figure 10: Performance Measure 3 ................................................................................. 6
Figure 11: Performance Measure 4 ................................................................................. 6
Figure 12: Other Performance Measure .......................................................................... 7

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List of Tables

Figure 13: Deviations from Measure Specifications 1 ..................................................... 7
Figure 14: Deviations from Measure Specifications 2 ..................................................... 8
Figure 15: Option Measure Stratification 1 ...................................................................... 8
Figure 16: Option Measure Stratification 2 ...................................................................... 9
Figure 17: Option Measure Stratification 3 ...................................................................... 9
Figure 18: Option Measure Stratification 4 .................................................................... 10
Figure 19: Optional Measure Stratification 5 ................................................................. 10
Figure 20: Optional Measure Stratification 6 ................................................................. 11
Figure 21: Optional Measure Stratification 7 ................................................................. 11
Figure 22: Final Comments and Report Documents ..................................................... 12
Figure 23: PCR Reporting – No - 1 ............................................................................... 12
Figure 24: PCR Reporting – No - 2 ............................................................................... 13
Figure 25: PCR Reporting – No – 3............................................................................... 13

List of Tables
Table 1: Acronyms ........................................................................................................ 14

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Plan All-Cause Readmission Rate (PCR) - Path 1

1. Health Homes Quality Measure
1.1

Plan All-Cause Readmission Rate (PCR) - Path 1

Figure 1: PCR Reporting – Yes

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1.2

Measure Specification - Path 1

Measure Specification - Path 1

Figure 2: Measurement Specification 1

1.3

Measurement Specification - Path 2

Figure 3: Measurement Specification 2

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1.4

Date Range

Date Range

Figure 4: Date Range

1.5

Definition of Population Included in the Measure

Figure 5: Definition of Population Included in this Measure 1

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1.6

Delivery Systems

Delivery Systems

Figure 6: Definition of Population Included in the Measure 2

1.7

Health Home Providers Representation

Figure 7: Definition of Population Included in the Measure 3

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1.8

Performance Measure (Checked all age range) Path - 1

Performance Measure (Checked all age range) Path - 1

Figure 8: Performance Measure 1

1.9

Performance Measure (Checked one age range) Path – 2

Figure 9: Performance Measure 2

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Age Range 65 and older, Path 1

1.10 Age Range 65 and older, Path 1

Figure 10: Performance Measure 3

1.11 Age Range 65 and older, Path 2

Figure 11: Performance Measure 4

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Other Performance Measure

1.12 Other Performance Measure

Figure 12: Other Performance Measure

1.13 Deviations from Measure Specifications

Figure 13: Deviations from Measure Specifications 1

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Optional Measurement Stratification

Figure 14: Deviations from Measure Specifications 2

1.14 Optional Measurement Stratification

Figure 15: Option Measure Stratification 1

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Optional Measurement Stratification

Figure 16: Option Measure Stratification 2

Figure 17: Option Measure Stratification 3

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Optional Measurement Stratification

Figure 18: Option Measure Stratification 4

Figure 19: Optional Measure Stratification 5

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Optional Measurement Stratification

Figure 20: Optional Measure Stratification 6

Figure 21: Optional Measure Stratification 7

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Final Comments and Report Documents

1.15 Final Comments and Report Documents

Figure 22: Final Comments and Report Documents

1.16 Plan All-Cause Readmission Rate (PCR) – Path 2

Figure 23: PCR Reporting – No - 1

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Plan All-Cause Readmission Rate (PCR) – Path 2

Figure 24: PCR Reporting – No - 2

Figure 25: PCR Reporting – No – 3

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Plan All-Cause Readmission Rate (PCR) – Path 2

Appendix A: Acronyms
Table 1: Acronyms
Acronym

Literal Translation

HHQM

Health Homes Quality Measure

PCR

Plan All-Cause Readmission Rate

PRA

Paper Reduction Act of 1995

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